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Use this guideline to assure you are ready to meet the preceptor. Consider each encounter with your potential preceptor and the impression you make with the office may influence a future employment opportunity. Dress in a manner that projects professionalism and competence.

Information to share with your preceptor:

  1. Clinical Roles and Responsibilities of the Student, Faculty and Preceptor: Copy the Roles
  2. Preceptor Agreement Form: Download the Form
  3. Site Survey: Download the Form
  4. Initial Request for Education Agreement (also referred to as the Memorandum of Understanding or Affiliation Agreement). Please check with USI1Nursing@usi.edu to determine an agreement between the university and the facility is already established. Download the Form
  5. Clinical hours required for the course (weekly clinical hours needed over the course of the semester).
  6. An updated CV/resume including your professional photo. One page total is suggested.
  7. Discuss elements of the clinical you need for the course such as collecting a patient history, performing focused physical examinations, developing a diagnosis list with differentials and developing patient plans of care for the preceptor to review. You will also need the preceptor to electronically verify your time via our third-party repository.

    Send the forms above to USI1Nursing@usi.edu